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UB-04 (CMS-1450) Health Hospital Insurance Claim Form, Laser 8-1/2' x 11' - Pack of 100 Forms

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$21.14

$ 9 .99 $9.99

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UB-04 (CMS-1450) Health Insurance Claim Form
Laser / Inkjet Format
24-lb, 8.5 x 11-inch (Letter Size)
100% Compliant with Approved Update to HCFA / CMS 1450 Health Claim Form

UB-04 (CMS-1450) Health Hospital Insurance Claim Form, Laser 8-1/2" x 11" - Pack of 100 Forms

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UB-04 (CMS-1450) Health Hospital Insurance Claim Form, Laser 8-1/2' x 11' - Pack of 100 Forms